Hypochlorhydria, it also impairs the breakdown & absorption of pharmaceutical drugs. So the net amount that actually makes it into circulation might be lower, especially in the case of thyroid medications whether its levothyroxine or a natural thyroid extract.
Welcome back to another episode, as we continue our discussion on stomach acid! But before we get on with our discussion, I’d like to point out that, as you’ll might’ve already noticed I’ve mentioned ‘Gut Health’ at the beginning of the title of these episodes, so that all the episodes that are gut health related would be easily recognizable.
Now we continue. Yesterday we spoke about stomach acid & discussed how sub-optimal stomach acid levels can give rise to so many problems. Today we’ll be looking at some of the most common factors that negatively impact stomach acid, along with looking at some of the most common symptoms associated with it. Followed by, some of the tests that can help to confirm if you have low stomach acid.
So lets get started with some of the primary causes having a negative impact on stomach acid. Starting with & I think you must’ve already guessed this one, ‘Stress’. It goes without saying, its one factor that’s involved in the causation of almost all health problems! If you’re stressed around & during your meal time, well, that’s going to hinder the release of stomach acid. When you’re stressed, your body switches to the sympathetic state aka fight or flight mode because it cannot distinguish between you being chased by a lion or by your boss. This is actually an important concept & we’ll have an entire episode dedicated to the sympathetic & parasympathetic nervous system states.
Then we have water. Drinking copious amounts of liquids during meals that’s another bummer. What happens when you mix water in acid? It becomes weak, right! Along with things like being distracted or eating on the go, gulping down your food, grazing on food throughout the day, overeating, all of this & more, which all forms a part of eating hygiene, in the absence of which digestion is broken.
Long term or regular use of certain medications like NSAIDs (non-steroidal anti-inflammatory drugs) which cause wear & tear on the stomach lining & remember, its the cells of the stomach lining that produce the acid (1) And medications like H2 blockers & PPIs (proton pump inhibitors) which are used for combating acid reflux also known as GERD, they also impair stomach acid (2) Sure, they do provide relief from acid reflux but consider this. Acid reflux is a result of insufficient stomach acid & these pharma drugs are just, further exacerbating the problem by suppressing the stomach acid & we know what that leads to! Its like, the plane’s going down & you jump off without a parachute! Its downright crazy!!
Its understandable if drugs are used for a short duration like for instances in this case, the short term use of these drugs in case of strong gastritis or ulceration while its being addressed is justified. But long term use will have severe health implications. And alpha blockers, beta blockers & opiates, basically drugs having a significant calming affect on the nervous system or ones that interfere with acetylcholine activity, they also disrupt stomach acid release.
Another common factor involved in formation of diseases, can you guess what that might be?Chronic inflammation! Inflammation kicks up the stress hormones which in turn puts the body in the sympathetic mode which greatly reduces activity in the digestive tract thus negatively impacting stomach acid release. And if this keeps happening like chronically, it won’t take time for H.pylori (Helicobacter pylori) to overgrow & take over. And this bacteria loves an alkaline environment so its basically going to add onto our woes by further neutralizing stomach acid. So, basically, processed, packaged & fast foods, foods with artificial additives, preservatives & flavorings, all contribute to inflammation. Even things like food sensitivities, alcohol abuse, overuse of antibiotics, they too cause intestinal inflammation.
Hypothyroid function, it too contributes to digestive issues because everything gets slow & sluggish and all cellular functions are impaired which also include the cells in the stomach lining that make & release stomach acid. While delayed gastric emptying courtesy to hypothyroid function, it also results in GERD & provides opportunity for bacterial overgrowths. Like, for example, SIBO (small intestinal bacterial overgrowth) which shares an intimate connection with low stomach acid, its like they’re lovers! When one’s present, the other is highly likely to follow!
Age is another factor. Given the modern society we live in where we are surrounded by pollutants, toxins, we don’t have enough sunlight exposure, we live away from nature, we have lots of stress, our food choices are very poor plus the quality is also most likely poor, plus a whole bunch of other stuff thrown into the mix. One can surely expect a decline in stomach acid levels & even digestive enzymes like pepsin, irrespective of h.pylori levels, as we age. Unless we take proper care & do what’s best for our well-being, that’s one of the things we can look forward to.
These are the most common factors leading to sub-optimal stomach acid levels. Sure there can be some other factors too like hormonal imbalance, gastric bypass surgery & an autoimmune attack on parietal cells, which is uncommon.
Now, moving on to symptoms, there are many many symptoms associated with sub-optimal stomach acid, considering the fact that, it eventually leads to a long list of deficiencies which have their own repercussions. Like for instances, bad breath, weak nails, skin issues, dandruff, constipation or diarrhea, fatigue, hair loss & breakage, food sensitivities and lots more. However the main ones to look out for are gas, bloating, belching after meals and heart burn, basically acid reflux which points out towards chronic indigestion. We’ll be covering more on acid reflux in the next episode since its important to manage it well in order to start addressing hypochlorhydria.
An early sense of satiety or heaviness during or post meals along with fatigue, undigested food in the stools, frequent gut infections, chronic allergies like urticaria, that’s hives on the skin. These things also point out towards low stomach acid.
Now, there are various tests which can help to determine & detect hypochlorhydria. I’ll first mention two simple tests that can be carried out at home which costs next to nothing. But you’ve got to take note that, there’s no reliable data or publication stating these tests to be fairly accurate or reliable. But there’s no harm in giving them a try. The first is a beetroot juice test. You simply drink a glass of fresh beetroot juice & later notice the color of your urine. If its clear, you’re not likely to have hypochlorhydria. However if the urine turns out to be of a pinkish hue, well, that confirms presence of sub-optimal stomach acid. The second test is carried out using baking soda. You have to mix ¼ teaspoon which is 1 gram of baking soda in 120 to 170 milliliters of water which is approximately 4 to 6 ounces. Use room temperature or cold water. Drink it on an empty stomach first thing in the morning before eating or drinking anything else. Then time yourself on how long it takes for you to burp or belch. It should occur within 5 minutes & if it doesn’t, that’s a sign of insufficient stomach acid production. Especially if the burps occur after the 3 minute mark, its also an indication of low stomach acid. However, if you experience early & repeated burps or a feeling of indigestion it may be due to excessive stomach acid. Since there are other variables that can impact the result, so its better to carry out this test on 3 consecutive mornings.
As for other tests, I’m not a big fan. Generally when I work with my clients, I rely on the symptoms & the case history of the person which actually says a lot. So, I keep testing as secondary, only when required. However, nevertheless, I’ll tell you about some of the tests that you can check out. There’s the most popular of all called ‘Heidelberg Capsule Test’. Its the gold standard of hypochlorhydria testing because it directly measures gastric pH. It costs around $350 & in most cases its not covered by insurance.
However you can opt for Routine tests like complete blood count & comprehensive metabolic panel, which are almost always covered by insurance also contain some markers which can be helpful in gauging stomach acid levels. If you remember in the last episode I mentioned that about chloride being a component in the formation of stomach acid, so the nest place to start would be chloride levels. Low chloride levels, under 100, in the blood is a sign of low HCL. And, since protein will not be optimally broken down in the presence of sub-optimal stomach acid, you can also look at serum protein & serum globulin levels are going to turn out abnormal. Serum protein if under 6.9 grams per deciliter or if its over 7.4 grams per deciliter will be an indication towards low HCL & serum globulin under 2.4 grams per deciliter or over 2.8 grams per deciliter, will also indicate the same as well. And all this you can only consider these markers if the liver enzymes are normal & you’ve been consuming sufficient levels of meats, basically protein. Plus, poor protein digestion results in a high nitrogenic waste in the bloodstream, so you’ll notice that the levels of blood urea nitrogen which is also called BUN will be elevated, it’ll be 20 or above.
And you’ll also find low mineral levels in your labs, especially iron & RBC zinc. And since iron will be low due to poor absorption, your hematocrit & hemoglobin levels are going to turn out to be low as well. B12 levels, that’ll also turn out to be sub-optimal. And when B12 levels are low, methylation will be negatively impacted & you’ll find that levels of homocysteine will be elevated. That’s another marker you could look at. There are many other lab markers that I can share with you along with some other tests but frankly, its not really needed especially considering the fact that, if you have some very obvious symptoms which we have just discussed today, you will be able to figure out whether you have optimal or sub-optimal stomach acid.
In the upcoming episodes we’ll be talking about acid reflux, GERD, in brief along with ways to address it, along with solutions to re-build your stomach acid levels & getting it back to optimal levels so you can start feeling great & getting healthy. I hope you’ll have an amazing week & I’ll see you at the weekend!